Pulsed Xenon Technology Targeting Hospital Acquired Infections, Cost and Outcomes Background and Introduction: Hospital acquired infections (HAI), frequently transmitted via contaminated environmental surfaces, affect 1.7 million patient infections and result in 100,000 deaths annually, along with substantial extra treatment costs. Recognizing increasing challenges of treating multiple drug resistant pathogens (e.g., MRSA, C.difficile), VA initiatives have targeted HAI reductions, such as screenings, active surveillance, and patient isolation. While transmission rates have declined, most preventive strategies to reduce infection are only partially effective, and proper disinfection is rarely achieved. Leveraging promising pilot data and close collaboration among VA facilities, this implementation study will determine the clinical and economic benefits of a powerful new decontamination technology, since hand cleaning of discharged patient rooms requires substantial time, labor and supply costs. The anticipated reduction in infection rates and future ramifications such as unnecessary readmissions, plus efficient use of VA resources, offer numerous strong advantages over current cleaning procedures. Future applications include use in other VA inpatient settings and contract nursing homes where HAI presents a significant problem for aging veterans. The Central Texas Veterans Health Care System alone experiences 8000 annual admissions/transfers, each necessitating an intensive cleaning. Unfortunately, manual efforts focusing on visible soiled areas are usually insufficient and unreliable (70% of high-touch surfaces are missed). However, portable machines emitting pulsed xenon ultraviolet rays (PX-UV) waves represent an effective, convenient solution for providing safer patient environments without disrupting hospital operations. PX-UV effectively kills many microbial pathogens with shorter cleaning times, yielding a practical, less expensive option for routine room disinfection. Our recent pilot study compared human-only efforts to PX-UV cleaning: MRSA and bacterial colony counts dropped precipitously and cost analyses were suggested lower expenditures for PX-UV devices. Yet wider implementation is needed to validate this work, and demonstrate global implications for routine quality improvement efforts. Proposed Methods: Our experienced multidisciplinary team will link facility infection control reports, observations of labor resources compared with new technology costs, and VA administrative data, this larger evaluation study will demonstrate the clinical impact, implementation feasibility, and cost- effectiveness of the innovative disinfection system. If PX-UV is clinically and economically superior to standard cleaning protocol while reducing adverse outcomes, we believe study findings can potentially revolutionize hospital procedures. At two intervention facilities, rooms and surgical suites will be disinfected with PX-UV, while two control sites will continue practicing standard manual cleaning. Infection control reports will be collected, documenting new HAI cases and microbial counts at selected high-touch room surfaces for multiple organisms. This information will be linked to patient-level administrative data extracts for diagnostic information, treatment costs, and health utilization variables. Addressing our primary objectives: 1) The clinical impact of this new technology will be assessed by differential reductions in microbial counts between intervention and control sites. 2) As a result, HAI transmission rates will significantly decrease; 3) Finally, a rigorous cost-effectiveness analysis will examine economic cost savings including labor time and fewer hospital days and use of antibiotics to treat HAI.